Morbid Obesity

Over the past 25 years a serious health crisis has occurred in our country, and it has not only caused devastating damage to individuals and families, but it is preventable.Billions of dollars are spent annually in health care costs by those who are affected, while others are likewise spending billions of dollars to treat and prevent the condition. The problem is obesity and left untreated can become morbid obesity in which a person is at least one hundred pounds over their ideal weight. As a nation and a culture we are simply eating ourselves to death.

During my years as a general surgeon I treated my share of patients who were morbidly obese. I confess I dreaded seeing such a patient referred to me for a surgical procedure, because the complication rates were so high and the mortality rates were also increased. I had a family practitioner who referred many patients to me for care, and he would frequently say something like this, “I have a lady who needs her gall bladder removed because of stones, and she is also suffering from acute biscuit poisoning!” It would have been funny were the patients not so prone to poor healing and infections. On one particular weekend I remember doing emergency gall bladder surgery on three women whose combined weights were eleven hundred pounds. Fortunately for my surgical team we were able to do the laparoscopic procedure on each of them, and this was physically much easier than the old-fashioned open procedure. And fortunately for the patients each of them healed with no complications.

When I transitioned into wound care for the last twelve years of my practice life I also treated many extremely obese patients. One of the many problems of morbid obesity is chronically swollen and edematous lower extremities. This can lead to open wounds of the lower legs, particular in a diabetic patient, and these wounds are hard to heal and prone to enlarge and become infected.

When I practiced at Washington Regional Medical Center in Fayetteville, Arkansas, one of my referring physicians was Dr. Tim Cogburn (fictitious name), an internist. His medical office was in the hospital building one floor above the Wound Care Clinic. Occasionally he would come to the clinic for a brief visit, and we would have a cup of coffee together. We became good friends, and he and his wife Darlene (fictitious) even joined our Sunday school class at University Baptist Church.

On one particular visit we were discussing a patient he had referred for treatment of a poorly healing leg ulcer. She was extremely obese, and the wound was requiring an unusually long time to heal. Tim said, “I send you quite a few of my patients with chronic wounds, and all of them are overweight. I understand all of the physical and emotional things an overweight person deals with because of my own experience. I understand the stress in an obese person whose only thoughts are about food, and the intense craving such an individual has for carbohydrates.” I didn’t comment on his remarks because Tim weighed in excess of three hundred pounds. Then he made a shocking statement when he said, “I’m just a shadow of my former self. A few years ago I weighed in excess of six hundred pounds!” He continued, “I knew as a physician I would not live much longer with that kind of weight so I had a stomach stapling procedure, and as a result lost over three hundred pounds.”

We had a brief conversation about the benefits of surgical procedures for extreme obesity, and I asked him, “How many calories a day does a person consume to maintain a weight of over six hundred pounds? Over ten thousand calories?” Tim said, “Probably so.” He continued; “Let me tell you a couple of things I did to satisfy my intense hunger pain.

Our home was approximately a twenty to twenty-five minute drive from my medical office. Within a block of our home was a doughnut shop which made the most delicious doughnuts I ever ate. I would stop there every morning and buy two dozen doughnuts, and I would eat every one of them while making the drive to the office.”  “You ate two dozen doughnuts every day?” I asked. “Yes sir, and then would have a snack of something sweet before lunch,” he said. I quickly calculated at two hundred calories per doughnut, he was consuming forty eight hundred calories daily in doughnuts alone.

“Another story about my food cravings is rather humorous,” he said. “Darlene and I love barbecue sandwiches, and there was a well-known barbecue cafe in town. She called one day and asked if I would stop by the cafe and bring sandwiches home for dinner. I ordered one jumbo-sized for her and four jumbo’s for me and started home. The odor of the freshly made sandwiches was too much for me to resist, and before I made it home I had eaten all five of the jumbo sandwiches. Darlene was so mad at me, and after an argument I agreed the next time I brought sandwiches home I would place them in the trunk of the car to prevent me from getting to them. That’s part of the harmful psyche of a morbidly obese individual.”

I confess I love to eat, and many of the foods I enjoy are not healthy when eaten as part of a regular diet. Fried catfish, chicken fried steak, hamburgers, French fried potatoes, cinnamon rolls, and almost any dessert dish are among my favorites. I have learned over the past few years since my intense exercise routines have diminished, eating all the foods I enjoy are a sure path to excess weight gain. Likewise when I restrict the intake of such high carbs I will lose weight. A simple formula for weight loss which I advised my surgical patients who asked is to increase your exercise program and decrease your caloric intake. It is no magic formula, but it works. Losing extra pounds and coming as close to one’s ideal weight will sure make your surgeon happy, and it might just prolong your life!

Dr. John

Cathy; George; Nancy – circa 1945

In the fall of 1964 when I was an intern at Grady Memorial Hospital in Atlanta, Georgia a friend named Marsha Moore arranged for me to have a “blind date” with Cathy Young, a fellow elementary teacher at her school. Marsha was married to a close friend and fellow intern Dan Moore, whom I had known since college days at the University of Arkansas in Fayetteville. This double date that night in Atlanta 55 years ago started Cathy and me on a beautiful and wonderful life journey and was the beginning of a life of grace together which was established in heaven.

After Cathy and I had been seriously dating for several months I had the privilege of meeting the first member of her family from Fort Lauderdale, Florida her mother, Virginia Young. At the time Virginia was President of the Florida School Board Association, and she was in Atlanta for a national meeting of State School Board Presidents. I think the real reason she came to Atlanta was to meet the young man who had been steadily dating her younger daughter and had gotten word we were considering engagement for marriage. The evening I met Virginia (Mom) I was just coming off ER duty at the hospital and still had on my uniform which was all white. There were a few spots of blood on my coat and pant’s leg from the day’s work, and for years afterward Mom would tell people, “When I first met John Henry in Atlanta, he had been on ER duty and was covered in blood!”

The Young’s were a pioneer family of Fort Lauderdale. Cathy’s grandfather, George W. Young came to Fort Lauderdale from northern England in the early 1900’s and began a construction business, which was the first of its’ type in the city and became one of the premier construction businesses in all of South Florida. Cathy’s Dad, George F. joined his father in the 1930’s, and became known for his mastery of custom design in homes while developing skill as an expert on steel and concrete. Many of the businesses on historic Las Olas Boulevard along with the Riverside Hotel as well as the Governor’s Club Hotel were built by Young Construction Company. During those busy years the company employed as many as one hundred and eighty laborers.

Cathy’s Mom was an outstanding person and unsurpassed politician in Broward County. For the decades between the 1970’s and 1990’s she was the best known woman in South Florida. In addition to raising three outstanding children along with her husband George (Dad), Virginia (Mom) was deeply involved in the education and political life of the people of Fort Lauderdale. From her position as State School Board Chairman she ran for and won a seat on the City Commission. For two separate terms she served as Mayor of Fort Lauderdale, and to this date is the only woman to hold the position. She also served two terms as Vice Mayor and later Mayor Pro Tem during her years of service for the city. When her time on the City Commission ended, she served on the Downtown Development Authority (DDA) for seven years helping preserve historic landmarks and direct new business development for this booming city.

The Young’s three children, George, Nancy and Cathy were able to grow up in a beautiful ocean-side city which was safe enough for young people to play on the beach unaccompanied by adults. Neighborhoods for the most part were not dangerous, and children could play without fear of kidnapping. Walking the streets and playing in yards in the evening and into the night could be done without parental observation.

Following high school graduation Cathy and her older siblings continued their education by attending Florida State University in Tallahassee. George led the way in 1955, and pursued a degree in education leading to his PhD in 1966 with a focus on student affairs. His first and only position outside of Florida was as Dean of Students at Valdosta State University in Valdosta, Georgia, and he and his wife, Dawn moved there in 1966. By this time they had two small children, Jenifer and George IV. He served this growing college between the years 1966 to 1969 and was offered a similar position as Dean of Students at Broward Community College in Fort Lauderdale. This was the same year I was commissioned as a medical officer in the U. S. Air Force at Moody Air Force Base in Valdosta. Cathy and I were initially so excited to live in the same town as George and his family only to discover they had decided to move. One of George’s last good deeds in Valdosta was to locate and secure for Cathy, our young son John Aaron and me a beautiful home which we rented for the two years we were stationed at Moody AFB. George continued in his role as Vice President of Student Affairs until his retirement  in the early years of 2000. He was such a recognized national leader in his profession he served in 1979-1980 as President of NASPA, the National Association of Student Administrators. With his election he became the first administrator from a community college to have been elected as President of this prestigious organization.

Nancy followed George in obtaining her degree in education at Florida State which she completed in 1961 with a BA with honors. She obtained her master’s degree from FSU in 1965 also with honors. Nancy’s first teaching position was in Sopchoppy, Florida where she taught in the elementary school.  She moved to Titusville, Florida on the east coast with her young son, Clay and continued teaching until she became an elementary school principal in the late 1960’s. At the urging of friends and colleagues Nancy decided on a career in law and moved with Clay in the early 1970’s to Gainesville, Florida. She got her JD degree from the University of Florida in 1977. By this time she had met and married Norman Smith from Kissimmee, Florida, and she joined Norman in his law firm of Brinson, Smith and Heller in 1977. She practiced law for over 35 years in her new firm; Brinson, Smith and Smith.

Besides her love of law, especially Family Law Nancy was an avid bass fisherman who knew and fished all the lakes of central Florida especially Lake Toho (Tohopekaliga). She was such a recognized expert on bass fishing she had a regular column in the Kissimmee News-Gazette describing  tips on where and how to catch the largest of the large mouth bass of Florida.

George and Virginia Young (Dad and Mom) each made tremendous impacts into the lives of people in Fort Lauderdale while raising three outstanding children who carried on the Young legacy. In my opinion the youngest of the Young children is the most outstanding member of a very wonderful family, and she happens to be Catherine Reta (Cathy), my wife for the past 53 years. I will admit to extreme prejudice, while at the same time am very grateful to the Lord for the blind date in Atlanta in 1964!

Dr. John